Understanding Mental Health Stigma

Introduction

Mental Health is referred to the behavioural, cognitive and emotional well-being of an individual that influences them to effectively think, behave and feel in the society. There are existing stigma regarding the mental health among individuals which leads individuals suffering from psychological issues face hindrances in accessing care and acceptance in the society. In this context within the assignment, the different concept of stigma is to be explored. The relation of stigma regarding mental health by considering existing health inequalities is to be discussed. The mental health issues to be focussed in this assignment are post-natal depression and explanation of stigma related to it is to be provided. Furthermore, the need for healthcare dissertation help highlights the importance of understanding these issues comprehensively. The service improvements for overcoming stigma regarding post-natal depression in the UK are to be discussed.

a. Explaining key theories or concept regarding stigma

The Goffman’s theory of social stigma refers stigma to be a behaviour, attribute or reputation that is socially discrediting in a certain way. The theory informs that social stigma causes people to be psychologically classified in the society as rejected stereotype, undesirable and unacceptable individuals (Vassenden and Lie, 2013). This indicates that social stigma makes an individual to be portrayed as stereotype making unable to lead a normally socially enhanced life. According to Goffman, there are mainly three types of stigma which are stigma of character traits, physical stigma and group identity stigma. The stigma of character traits is the one in which blemishes and hindered aspect present in individual character is considered as domineering, dishonesty, rigid and harmful beliefs, weak will or unnatural passion and others. These are being interfered with records of mental disorder, alcoholism, homosexuality, suicidal behaviour and others (Setchell et al., 2017). This means that based on individual character stigma is considered in this type.

The physical stigma is referred to wrong and stereotypical beliefs in relation to physical deformities of the body (Young et al. 2019). For example, blind people are often physically stigmatised to be weak and invisible in the society which leads them to face lack of social acceptance in society (Gernsbacher, 2017). The stigma of group identity is the stigma which is raised from being a person of particular religion, race, ethnicity and other. The group stigma is transmitted through lineages and adversely contaminates the minds of all family members with ongoing generation (Tyler, 2018). For example, often Muslim religion is stigmatised as religion with adversity due to which people perceive the group to be violent and pass the information in the family to consider the people of the religion to be same over generations. The Goffman’s theory mentions that there are two types of people based on stigma which are discredited and discreditable. The discredited is referred to individuals whose signs of stigma regarding any aspect are known whereas discreditable are referred to individuals whose stigma is not known (Chaudoir et al., 2013). For example, discredited stigma are referred to individuals who show visible stereotyping of people like stigmatising people based on caste, race, gender or physical disability. However, discreditable stigma is mainly concealable like stigma regarding sexual minority, HIV, mental health and others (Chaudoir et al., 2013).

The other concepts regarding stigma include enacted stigma, internalised stigma and anticipated stigma. The enacted stigma is referred to external discrimination in which individuals in the society are unfairly treated by others (Wei et al. 2016). The internalised stigma is referred to absorption of negative perception and attitudes within oneself which prevents them from talking regarding it in the society and by gaining control over pain avoids seeking help regarding it (Griffiths et al., 2016). For example, people with acute mental health condition like posttraumatic stress disorder (PTSD), acute stress disorder and others often stigmatise the condition to be incurable which leads them to avoid accessing care for the mental health issues that could be better managed with medical intervention (Lau et al., 2017). The concept of anticipated stigma is referred to the belief that discrimination, prejudice and stereotyping by one are to be passed from them to others in the coming future. For example, people with chronic mental illness like Schizophrenia develop anticipation that they will be devalued and further stigmatised for their health condition also in the future (Krupchanka et al., 2016).

b. Explaining relation of stigma to mental health by considering related health inequalities

There are wide amount of stigma regarding mental health which is mainly due to presence of various health inequalities regarding the management of the illness. According to Clement et al. (2015), enacted and anticipated stigma is instigated regarding mental health due to unequal distribution of health awareness and education regarding mental illness. This is because without awareness and education the individuals in the society are unable to understand the scientific and medical causes of the mental illness making them to internally stereotype the condition and pass the information to the future individuals. The lack of educational awareness also leads people affected by mental illness consider that in the future individual would remain unaware of the true facts regarding the reason of mental illness making them continue the stigma regarding the health issue in future. For instance, in the contemporary condition people out of lack of proper awareness regarding schizophrenia, stigmatise people suffering from the condition as violent due to their problematic behaviour. At present, people suffering from the illness consider negative information for schizophrenia to be passed on to generation in the society who due to lack of education regarding the reason behind their hindered actions would internalise the fact and continue discriminating them (Zäske et al., 2016).

In contrast, the study by Bevilacqua et al. (2017) mentions that inappropriate and biased delivery of information by the mass media related mental illness makes people develop internalised stigma regarding the disease. This is because in mass media it is often seen that people with mental illness are portrayed as villain making them be considered as aggressive and unwanted in the society. The people affected by mental illness internalise the fact which raises stigma within them to avoid seeking care as they think it would make them be proved as vulnerable individual in the society who would be isolated from others. Thus, the fear of isolation and vulnerability as portrayed in the mass media makes people consider the pain with their illness and avoid seeking care to resolve it. As commented by Daniel (2017), unequal availability and distribution of healthcare services among different class in the society for individuals have profound effect on raising stigma regarding mental health. This is because unequal healthcare service delivery leads many people with mental health complication of lower class unable to avail support required to improve their health and perception regarding mental illness. It leads them to internalise the fact that no help is there to protect them from mental complication and the consideration leads them to discriminate mental illness to be incurable or have no treatment in certain social classes (Lavie-Ajayi et al. 2018).

The stigma regarding mental health is raised out of unequal religious and cultural beliefs and perception of the disease. This is because in certain culture like in the Western communities it is seen that mental illness is considered as illness of the mind but in South Asian communities it is seen that mental illness is culturally considered as an act of God for the sinful deeds of the people and there is no treatment regarding it. It leads people of the South Asian culture to stigmatise people with mental illness to be bad and unacceptable in the society making the people suffering from the disease avoid disclosing their disorder for accessing healthcare (time-to-change.org.uk, 2019).

c. Explanation regarding post-natal depression and stigma related to it

The study by Slomian et al. (2019) mentions that post-natal depression is one of the mental health condition commonly faced by mothers after the birth of their child. It is evident from one of the statistics shared in the study where post-natal depression prevalence is mentioned to vary from 5.2% to 74% in developing countries with the lowest figures to be found in Pakistan and highest in Turkey. The reason behind the differences in prevalence is inadequate resource availability for the diagnosis of the condition and effective awareness regarding the issue (Norhayati et al., 2015). The exact cause of post-natal depression is not known. However, the presence of history regarding depression and stress, hindered biological functioning, lack of management to create change in lifestyle after birth of the baby, strained relationship with partners and others are considered reason that leads to depression among mother are birth of their babies (Netsi et al. 2018).

The statistics regarding the prevalence of post-natal depression in the UK mentions that within the first year of birth of the babies 1 in 10 mothers develop postnatal depression (NHS, 2019). This indicates that the prevalence of mental health is quite high as many mothers are found to be affected by the mental health condition. The NHS mentions that 58% of mothers who develop postnatal depression do not seek medical intervention. This is mainly due to their lack of education and awareness of the condition and fear of the consequences and stigma to be faced as a result of the problem (NHS, 2011). Thus, the statistical data informs that more than half of the mothers in the UK who are suffering from post-natal depression do not seek medical intervention. As mentioned by Moore and Ayers (2017), mothers suffering from post-natal depression are often stigmatised in the society as bad mothers. This is because the hindering psychological health of the mothers which makes them incapable to properly care for their newborn leads others in the society to criticise them as unskilled to be a responsible mother. The condition can be related with internalised stigma where negative absorption of perception leading individuals avoids seeking help (Griffiths et al., 2016). In this condition, the ashamed feeling of being regarded as bad mothers may have lead many women suffering from post-natal depression internalise the fact and avoid seeking diagnosis of their condition. This is because they fear that revealing their mental health condition would make them stigmatised in the society (Bodnar-Deren et al., 2017).

The internalised stigma regarding post-natal depression which makes mothers avoid seeking care for the condition eventually impacts them to develop suicidal thoughts and self-harm. This is evident as in between 2009 to 2014 it is mentioned that 111 pregnant women and new mothers in their first year of birth died by executing suicide making post-natal depression a prime cause of death among women following birth of their child (birthtraumaassociation.org.uk, 2020). The stigma regarding post-natal depression leads family members to unfairly treat the mothers indicating that their low mood and feeling of sadness along with lack of energy vague reason to avoid the responsibility of caring for the child (Knight, 2019, Thorsteinsson et al. 2018). This nature of enacted stigma where mothers are unfairly treated and stereotyped by the family in the society led the mothers to develop the intention of self-harm to overcome the pain. The enacted stigma regarding post-natal depression also impacts the mothers to face lack of strong bonding with the babies and ensure their effective development through effective performance of their maternal role. This is because the mothers are unable to overcome the symptoms of the post-natal depression without support from the family making them physically as well as psychologically incapable to properly care for the child to develop bonding (Wei et al. 2016).

The mothers suffering from post-natal depression on recovery or while accessing care avoid communicating or interacting regarding the condition as they feel lack of safety. This is because the prevalence of stigma regarding it and low education make post-natal depression still not acceptable in the society and may make mothers face vulnerable conditions of abuse or harm on revealing their condition (Rodriguez et al., 2019). This indicates there is presence of discreditable stigma regarding post-natal depression where the psychiatric disorder is hidden by the mothers even after their recovery to ensure they live a normal life with safety and not being ashamed. The discreditable stigma leads to create an environment where no active awareness regarding psychiatric disorder is created. This is because the suffer hide their condition making the mental illness unable to be known to others in the society to perceive its effect. The nature of stigma regarding postpartum depression affects many mother's experience relapses of the symptoms regarding the condition making them feel increased fatigue, continuous agitation and anxiety, hindered sleeping, loss of appetite and others (Caan, 2016). This is because without awareness of the condition which is already been faced by others makes individuals not able to perceive how it may affect them creating a situation of ignorance regarding the mental health condition.

The stigma regarding post-natal depression not only affects the mother but also hinders child development. This is because mothers on avoiding seeking care for post-partum depression out of shameful feeling due to the presence of stigma makes them unable to focus on child care and ensure effective breastfeeding. During the early years, effective breastfeeding is essential for child growth as the breast milk contains vital vitamins and nutrients required for progressive bone and muscle development of the child (Chong et al., 2016). However, persistent symptoms of post-natal depression like fatigue, fear of harming the child, agitated behaviour and others make mothers have lack of energy and invest time in feeding the baby (Webber and Benedict, 2019). Thus, it leads to hindered care of the child as a result of the mother’s mental health.

d. Explaining service improvement to overcome stigma

The existing stigma regarding post-natal depression can be resolved through effective and active healthcare service improvement in the UK. As mentioned by Harrison et al. (2017), improvement of education and health awareness regarding health issues that are stigmatised is to be provided to resolve the stigma. This is because stigmas are mainly developed out of lack of education that instigates stereotypical thoughts and wrong perception regarding health issues. In the UK, though few structured health promotion regarding post-natal depression is present yet there is need for higher amount of educational programs for the condition (assets.publishing.service.gov.uk, 2018). Thus, in the UK, the service improvement for post-natal depression is to currently focus on developing increased health promotion campaigns regarding the mental health issue. This is to ensure wider education and right information regarding the health issue is provided to resolve stereotypical thoughts which would lead increased individuals suffering from the disease reveal to access care without fear of stigmatisation. As argued by Corrigan (2016), lack of structured healthcare policies and support leads to increased stigma regarding any disease. This is because without structural support openness to discuss and access care for the health issues along with resources and strategies to overcome stigma cannot be arranged. In the UK, no separate policy or legislation is present that effectively guides the way stigma regarding post-natal depression is to be resolved. This indicates that in the UK a better structural support policy for post-natal depression is to be created where well-develop strategies and adequate resources to increased health services for the condition and overcoming of the stigma related to it are present.

In order to overcome stigma, open interaction regarding the mental health issue is to be created within the society. This is because open conversation regarding stigma about any disease helps individuals to informs the reason of the stereotypical behaviour and discriminative thoughts regarding the issue as well as understand through discussion in conversation the wrong concept they have which are to be avoided to ensure avoidance of stigmatisation (Aggarwal et al. 2016). It indicates that in the UK the services improvement related to post-natal depression is to be made in such a way so that open communication regarding the mental health issue is created in the society. This is because in current condition well-structured open interaction is not effectively available regarding post-natal depression (rcog.org.uk, 2018). An empowering care environment is to be built for overcoming stigma regarding mental health. This is because in most cases the people suffering from mental illness are unable to avail care by overcoming the stigma as they feel lack of empowerment and empathy along with support to take the bold actions (Grose et al. 2019). Thus, the service improvement for resolving stigma about post-natal depression in the UK require to include creating an empowering and supportive care environment for the people to overcome the condition and reveal themselves for care.

In the UK, service improvement for managing stigma regarding post-natal depression is to include focus on creating a positive picture regarding the condition. This is because in the existing condition in the UK it is seen that effective positive support and support are not available for many mothers to reveal their condition of post-natal depression which is creating the stigma regarding the health issue to remain in-depth in the society (rcog.org.uk, 2018). In this purpose, the mass media is to be used who are to form advertisement that promotes positive consequences of post-natal depression treatment and reason behind the mental issue not to be stereotyped. This is because without debunking the myths and stereotypes through mass awareness stigma regarding any nature of mental illness cannot be resolved (Smith et al. 2019). The words to be used in promoting any health issues to overcome stigma is required to be appropriately selected. This is to ensure the words do not hurt the emotions and beliefs of the people as it would lead them feel insulted and avoid accepting the facts to overcome their stigmatisation of health issues (Bye et al. 2018). In the UK, people of various cultures and origin are present due to which right choice of words for promoting post-natal depression in overcoming stigma is to be made. This is because in such a way holistic participation from the population out of value and respect can be received for managing and overcoming myths regarding post-natal depression to ensure effective care environment for the people suffering from the condition.

Conclusion

The above discussion informs that there are various forms of stigma present in the society. According to Goffman, the three types of stigma in healthcare are stigma of characteristics trait, physical stigma and stigma of group identity. The people stigmatising the health issues can be differentiated as discredited and discreditable. The discussion regarding stigma of mental health problem indicates that myth and stereotyping health issues at first affect the individuals suffering from the condition hide their health problem from the society. This is because they do not wish to be ashamed or isolated. The stigma also impacts people with mental health problem such as post-natal depression develop relapse of their condition along with face hindrance in bonding, breastfeeding and playing maternal role for the child. The stigma affects people to feel helpless in the society and avoiding accessing care for the condition out of fear of being revealed. The service improvement to overcome stigma regarding mental illness such as post-natal depression in the UK require to ensure upgrdation of education, promote empowerment of people, create better health promotion, develop openness and others.

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